盐皮质激素受体
医学
肾脏疾病
糖尿病
醛固酮
药理学
2型糖尿病
内科学
罗格列酮
螺内酯
内分泌学
作者
Lan Yao,Xianhui Liang,Pei Wang
出处
期刊:American Journal of Physiology-endocrinology and Metabolism
[American Physiological Society]
日期:2023-06-01
卷期号:324 (6): E531-E541
被引量:3
标识
DOI:10.1152/ajpendo.00022.2023
摘要
Approximately 30%-40% of patients with type 1 or type 2 diabetes (T1D/T2D) develop diabetic kidney disease (DKD), which can lead to end-stage kidney disease (ESKD). Angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, and sodium-glucose cotransporter 2 (SGLT2) inhibitors have been investigated as treatments for DKD. However, these drugs do not prevent overactivation of the mineralocorticoid receptor (MR). Studies have shown a correlation between MR hyperactivation, renal injury, and DKD. Finerenone, a novel and selective nonsteroidal mineralocorticoid receptor antagonist (NS-MRA), was approved for the treatment of patients with DKD, and is associated with lower rates of hyperkalemia. Other NS-MRAs (such as KBP-5074, BR-4628, esaxerenone, and apararenone) may also be effective drugs for the treatment of DKD. This review summarizes the effects of pharmacological MR blockade on diabetes and diabetes-associated CKD, with a particular focus on the therapeutic mechanisms of NS-MRAs in preclinical studies and ongoing clinical studies. Further investigation of combined treatment with renoprotective drugs and NS-MRAs to improve the treatment of DKD is needed.
科研通智能强力驱动
Strongly Powered by AbleSci AI